Adaptation of the Score for Allergic Rhinitis in the Chinese Population: Psychometric Properties and Diagnostic Accuracy

Simon Ching Lam, Cheryl Chi Yan Yeung, Jackie Ho Man Chan, Dave Wan Choi Lam, Angie Ho Yan Lam, Isabella Annesi-Maesano, Jean Bousquet

Research output: Journal article publicationJournal articleAcademic researchpeer-review

19 Citations (Scopus)


Allergic rhinitis (AR) is a worldwide health problem with rising prevalence. To enhance the estimation of AR prevalence in epidemiological studies, the Score for AR (SFAR), a screening tool, has been developed and widely used. An 8-item SFAR is a handy, self-administered instrument assessing the information on nasal and eye symptoms, seasonal increase in symptoms, skin test results, and previous AR diagnoses. This study aimed to adapt the SFAR to the Chinese population (CSFAR) and validate it by testing its psychometric properties and diagnostic accuracy. Methods: This methodological study involved translation and validation phases. Different batches of participants were recruited for the above purposes. Results: In phase 1, the CSFAR obtained satisfactory item (80-100%) and scale level (97.8%) semantic equivalence, content validity index (96.7%), comprehensibility (100%), cross-language testing (? = 0.44-0.83 for item-to-item agreement; intraclass correlation coefficient [ICC] = 0.95, p 0.05-0.001). In phase 2, CSFAR showed satisfactory internal consistency (a = 0.83), 1-month (ICC = 0.88) and 1-year stability (ICC = 0.85), and construct validity (significant correlation between CSFAR and impairments induced by AR: r = 0.47, p 0.001). Based on the receiver-operating characteristic curve, comparing the CSFAR with diagnosis made by specialists, an optimal cutoff value was 6 (sensitivity 81.8% and specificity 80.3%). Conclusion: SFAR was translated into a Chinese version, the CSFAR. Satisfactory results were obtained for its equivalence, appropriateness, comprehensibility, and relevance, as well as its reliability and validity. A cutoff value of 6 was recommended to increase the diagnostic accuracy in environments with less pollen. This study provides evidence that the SFAR we adapted for the Chinese population is a valuable tool in AR screening.

Original languageEnglish
Pages (from-to)213-224
Number of pages12
JournalInternational Archives of Allergy and Immunology
Issue number4
Publication statusPublished - 1 Sept 2017
Externally publishedYes


  • Adaptation
  • Allergic rhinitis
  • Chinese population
  • Psychometric testing
  • Validation

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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